1. BAR - bright, alert, responsive 2. QAR - quiet, alert, responsive 3. QAD - quiet, alert, depressed 4. dull (depressed) 5. disoriented (headpressing, dementia) 6. obtunded (poorly responsive) 7. stuporous (sleeps all the time) 8. coma (cannot be aroused)

Small Animal Neurologic Diagnosis Flashcards by Sally June

The goal of a neurological exam is

to understand the functional basis for the nurological disorder

most people only remember about 10% of what you tell them

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components of the neurological exam

observation

postural reactions

spinal reflexes

sensation - presence, absence or diminished

cranial nerves

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observation

mentation
behavior
posture
gait

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mentation

BAR - bright, alert, responsive
QAR - quiet, alert, responsive
QAD - quiet, alert, depressed
dull (depressed)
disoriented (headpressing, dementia)
obtunded (poorly responsive)
stuporous (sleeps all the time)
coma (cannot be aroused)

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behavior

friendly, calm, sweet
anxious
nervous, hyperactive
manic
obsessive, compulsive
aggressive
dangerous

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posture

legs are an equal distance in the sagittal plane
pelvis is level
pelvis is symmetrical
leg length is equal
optimal alignment
meximal support
full mobility

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gait

stance phase
swing phase
stride

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stance phase

the foot is on the ground

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swing phase

foot is in the air

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stride

from foot fall to lift off, and back to foot fall

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evaluating lameness in dog - watch the head

step forward with bad leg - head goes up - opposite in back legs

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posturaal reactions

postural tone

proprioception
placing
hemistand
hopping
wheelbarrow

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postural extensor tone

tests ability to resist gravity
safe for largest dogs
place palm under paw - push up - they should resist you
flex the limb, 3 leg stance
lateral pelvis tilt suggests weak gluteal

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postural extenstion thrust

tests the vestibulospinal pathway

normal animal takes a step forward or back to restore balance

response absent or weak with central vestibular disease

lean dog forward - next response is for dog to step forward

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deficient proprioception

tendency to bear weight on dorsal aspect of paw

delay in swing phase of gait

excessive flexion, abduction, adduction

postural sway or ataxia

dog on concrete - dog dragging toes - dorsum

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proprioception test

flip paw onto its dorsal surface, rest it on the ground

allow time to correct the malposition

absence of correction - CP deficit

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knuckling is a sign of

deficient conscious proprioception

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neurologic sign of knuckling - information from limb mechanoreceptors is conveyed in the

dorsal column - medial lemniscus

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the axons ascend ipsilateral, synapse in the nucleus gracilis, decussate in the ___ synapse in the ___ and disperse in the __

medulla
thalamus
cortex

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ataxia

incoordination

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ataxia

incoordination

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sway while standing or walking

faster gaits may be relatively normal

primarily carried by spinocerebellar tracts

tested by lateral pull on the tail or push on hip - do they correct or fall over

ataxia

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ataxia is a sign of

deficient unconscious proprioception

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unconscious proprioception - UCP

maintains posture when sitting, standing, and walking

axons travel int he spinocerebellar tracts

processed in the ipsilateral cerebellum

test for postural sway

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clinical sign of UCP

ataxia

conscious proprioception - CP

facilitates complex motor activity (catching a frisbee) axons travel in the dorsal columns (DCML) large myelinated fibers processed in the contralateral cortex

clinical sign of CP

knuckling while stanidng or walking

motor function strength

palpate for tone, symmetry, and depth

weak muscles are

soft or atrophied/flaccid

inhibited muscles have

normal mass but are inactive

facilitated muscles have more activity than

normal (spasm) from summation of impulses or weak antagonists

motor function spasms

hypertonic fibers that spontaneously contract

cause spasm

``` muscle weakness joint injury UMN disease dehydration electrolyte imbalances ```

sign of UMN disease

hyper-reflexia “parents” are not functioning

UMNs originate in the

motor cortex

UMN axons descend in the

corticospinal (pyramidal) tracts

UMNs initiate and maintain

voluntary movement

UMN control the nerve (LMN) that directly control

muscular activity

UMN tell LMN

what to do

LMN tell muscles

what to do

maintain extensor muscle tone, thus supporting the body against gravity - regulate posture

UMN

UMN helps maintain

muscle tone

LMN originate from

the spinal cord

LMN directly innervate

muscles and neuroeffector tissues

Signs of LMN disease

flaccid paresis to paralysis diminished reflexes rapid muscle atrophy loss of sensation in associated dermatome

LMN signs indicate a lesion affecting the spinal segments giving rise to

the nerve root, peripheral nerve, or the muscle

LMN children

not playing

late, mild muscle atrophy

UMN

normal to increased tone

UMN

spastic paresis

UMN

normal to hyperreflexia

UMN

decreased proprioception decreased nociception

UMN

rapid muscle atrophy

LMN

faccid paresis to paralysis

LMN

hyporeflexia

LMN

loss of sensation in associated dermatome

LMN

local paresthesia or hyperesthesia

LMN

most common site for disc injury in dogs

T12-L1 hyperreflexia

a group of muscles innervated from a single spinal segment

myotome

femoral nerve myotome

L4, 5, 6 L5

obturator nerve myotome

L4, 5, 6

cranial gluteal nerve myotome

L6, 7, S1

caudal gluteal nerve myotome

L7, S1, 2

sciatic nerve myotome

L6,7,S1, 2

pudendal nerve myotome

S1, 2, 3

Myotomes for the pelvic limbs

``` femoral nerve obturator nerve cranial gluteal nerve caudal gluteal nerve sciatic nerve common peroneal nerve tibial nerve pudendal nerve ```

myotome - femoral nerve - L4, L5, L6 (canine)

muscles that flex the hip, extend the stifle iliopsoas, quadriceps, sartorius, iliacus dogs compensate well for this by using abs to swing them forward

myotome - obturator nerve - L4, L5, L6

muscles that adduct the thigh

myotome - cranial gluteal nerve - L6, L7, S1

muscles that abduct the thigh

myotome - caudal gluteal nerve - L7, S1, S2

muscles that extend the thigh

TFL | piriformis

cranial gluteal

superficial and middle gluteal

caudal gluteal

myotome - sciatic nerve - L6, L7, S1, S2

muscles that flex the stifle and extend the thigh hamstrings biceps femoris, semimembranosus, semitendinosus

myotome - peroneal nerve - L6, L7, S1, S2

muscles that flex the hock and extend the digits sciatic nerve

myotome - tibial nerve - L6, L7, S1, S2

muscles that extend the hock and flex the digits sciatic nerve

myotome - pudendal nerve - S1, S2, S3

muscles of the perineum urethral sphincter, anal sphincter, caudal rectal,

urinary incontinence in spayed female dog gets up and was laying in own urine

adjust their sacrum - doesn’t work then go to drugs, proin cucin

spinal reflexes

tonic neck cutaneous trunci patellar withdrawal

muscle under skin - horse flinches skin when fly on them

cutaneous trunci

tonic neck reflex

should stiffen front legs when lifting head and pressing on shoulder blades

run hemostat down spinal column both sides - will stop panniculus reflex at segment of disc herniation

cutaneous trunci

lesionsof the brachial plexus cause a loss of reflex caudal to C-T1

cutaneous trunci

spinal cord lesions T3-L3 cause a loss of reflex 2 segments caudal and ipsilateral to the lesion

cutaneous trunci gently pinching the skin - always explain what you’re doing

patellar reflex

patellar ligament/tendon

neurological exam - reflex response scale

``` 0 - no reflex - LMN 1 - diminished; hyporeflexia - LMN 2 - brisk, modulated - normal 3 - increased; hyperreflexia - UMN 4 - increased, prolonged; clonus - UMN ```